Health Insurance: Changing Healthcare With Aetna (cxotalk #317)

The healthcare system, it definitely needsto change.

What’s the role of the insurers in that system? Today, on CXOTalk, we’re speaking with someonewho is driving change at a major healthcare insurer.

I’m an industry analyst and the host of CXOTalk.

I want to give a huge shout out to IPsoft.

We are in their AI Experience Lab in.

The heartof the financial district in New York City.

Before we go any further, tell.

Your friends,tell your family, subscribe on YouTube. We’re speaking with David Edelman, who isthe chief marketing officer. Hey, David, how are you? I’m doing great, Michael.

Have to say congratulations, firstoff, because once again you were selected as one of.

The most influential CMOs in theworld by Forbes.

To my team because,without them, none of that. It’s terrific to have such a great team. Tell us about Aetna, your size, your focus. I think everybody knows the Aetna brand buttell us about Aetna and tell us about your role. Aetna is actually a 165-year-old company,incredible heritage, focused on all different kinds of insurance starting with fire insurance,originally, and moving through and now focusing purely on the healthcare space. We have dedicated ourselves in.

Healthcareto change the way insurance companies work with people to manage their overall healthneeds. I’ll be talking about that as we go forwardin our discussion. Why is healthcare so complex? Healthcare is complicated because there areso many different parties. They are not very well connected. The payment mechanisms are convoluted, andit’s very hard to assess what is quality, what is a good outcome. And so, you don’t really know what you payfor.

Many times do you actually decide, “Okay. I don’t really know how good it’s going tobe. I’m going to take it home and then, threeweeks later, I’m going to get a bill”? That’s the way healthcare works. It’s quite convoluted because of.

The way thewhole system has been set up. That leads to disincentives to really managethat as a tight system that’s focused on helping keep people healthy at the most efficientcost. When you say that there are disincentives,can elaborate on that? It seems like a root issue that’s going onhere. Well, if you pay people in the healthcaresystem based on what they do, there’s an incentive to do — to actually generate action in orderto. That is not necessarily what people need.

Lot of incentivesfor different parties to work together to create a total outcome. One of the biggest problems — frankly, thisis a problem in many businesses, in general, it’s a problem in healthcare writ large — isthat every different component is optimized for just that component.

See a doctor, that doctor is focusedon that visit. In the lab, they are just focused on tryingto take care of.